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Health Facilities Licensure and Certification:

In-Home Care Initial Licensure Procedure Instructions and Information

HFLC In-Home Care Initial Licensure Procedure Instructions and Information

Last updated 02/2018

HFLC In-Home Care (IHC) Initial Licensure Procedure Instructions and Information

Table of Contents

1. IHC Frequently Asked Questions

2. IHC Initial Licensure Application Policy and Procedure

3. IHC Initial Policy and Procedure Attachment 1 ? Initial IHC Tracking Form

4. IHC Initial Policy and Procedure Attachment 2 ? Initial Application Letter #1 (1st letter)

5. IHC Initial Policy and Procedure Attachment 3 ? Initial Application Letter #2 (2nd letter)

6. IHC Initial Policy and Procedure Attachment 4 ? Initial Licensure Checklist

7. IHC Initial Policy and Procedure Attachment 5 ? Initial Survey Exit Checklist

8. Flow chart IHC Initial ? Phase 1 agency preparation guide

9. Flow chart IHC Initial ? Phase 2 agency application guide

10. Flow chart IHC Initial ? Phase 3 application review guide

11. Flow chart IHC Initial ? Phase 4 initial survey guide

HFLC In-Home Care Initial Licensure Procedure Instructions and Information

Last updated 02/2018

Health Facility Licensing and Certification 800 NE Oregon Street, Suite 465 Portland, Oregon 97232 971-673-0540 971-673-0556 (Fax)

In-Home Care (IHC) Agency Frequently Asked Questions

1. What is an In-Home Care Agency? An in-home care agency is an agency primarily engaged in providing in-home care services (including personal grooming, mobility assistance, nutrition/hydration assistance and others) for compensation to an individual in that individual's place of residence. In-home care agencies are not home health agencies; they do not provide home health services as defined in the Oregon Revised Statutes (ORS 443.005).

2. Who must be licensed? You must become licensed as an in-home care agency if you are providing in-home care services and doing one or more of the following: 1) scheduling caregivers, assigning work, 2) assigning compensation rates, 3) defining working conditions, 4) negotiating for a caregiver or client for the provision of services, or 5) placing a caregiver with a client. To determine if your future business qualifies as an in-home care agency, please see our determination form online at hcrqi.

You do not need to be licensed, if your business is only providing housekeeping and supportive services such as laundry or shopping and errands.

3. What type of services do In-Home Care Agencies provide? Types of services that in-home care agencies provide include but are not limited to: bathing, personal grooming and hygiene, dressing, toileting and elimination, mobility and movement, nutrition/hydration and feeding, housekeeping tasks, laundry tasks, shopping and errands, transportation, and arranging for medical appointments. Inhome care agencies may also provide medication and nursing services, but these services require additional conditions for approval. These conditions include additional policies and procedures and a nurse on staff.

HFLC IHC Initial Agency FAQ last updated 02/2018

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4. Where can I find the Statutes and Rules for In-Home Care Agencies? The Oregon Revised Statutes (ORS) (Chapter 443) can be found online hcrqi. The Oregon Administrative Rules (OAR) (Chapter 333, Division 536) can be found online hcrqi.

5. What do I need to do to apply for an In-home Care Agency License? ___ Read and understand all the Oregon Administrative Rules found online at hcrqi. ___ Fill out an in-home care application, found online hcrqi. ___ Include a check or money order for the correct fee amount (see application) payable to the "Oregon Health Authority" Please note: the fee is non-refundable; make sure you are absolutely certain you are prepared to be a licensed IHC before sending in the application and fee.

___ Include an administrator application and resume for your administrator. The resume:

? Must be current ? Must show evidence of at least two years of professional* or

management* ? experience in a health-related field or program ? Must include:

-the employer's name and location -the dates of employment including month and year -the title of the position held -the detailed description of duties performed ? Must show evidence of high school diploma or equivalent

*These terms are defined in rule: OAR 333-536-0005(13) & (21)

___ HCRQI Background Check Request Form. Any owners or administrator that have direct contact with clients must submit this form. The form is online at hcrqi.

___ Develop ALL policies and procedures (including associated forms such as the service plan form, disclosure form etc.). With the initial application package, include the following policies and procedures sections covering all rule components within the specific OARs, with the applicable forms, outlined below:

? Organization, Administration, and Personnel (333-536-0050) ? Disclosure, Screening, and Acceptance of Clients (333-536-0055)

HFLC IHC Initial Agency FAQ last updated 02/2018

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? Service Plan (333-536-0065)

___ Send application, fee, resume, background check request forms and the three policies and procedure sections listed above, and associated forms to:

HFLC IHC Survey Team PO Box 14260 Portland OR 97293

Incomplete applications will not be processed until complete.

6. When does the survey happen and what will it entail?

When the agency has successfully completed all steps in the initial licensure process, an initial onsite survey will be scheduled. The survey will be scheduled for a date and time which is agreed upon by yourself and the surveyor who will conduct the survey.

During the initial survey you will need to have all your policies and procedures identified in Oregon Administrative Rules, Division 536, ready for review by the surveyor. All policies and procedures should be well-organized and easily identifiable for the surveyor to review. Please ensure that you have created all required policies and procedures by IHC rules found online hcrqi.

A policy is a principle or a predetermined course of action to guide decision making.

A procedure describes a method to carry out a policy and often includes a series of steps.

A form may be part of a procedure that will be used to carry out a procedure.

During the survey the following should be ready for review:

A. The agency's policies and procedures for operating and providing services as an n-Home Care Agency in Oregon, which includes the policies and procedures identified by the Oregon Administrative Rules Division 536, Chapter 333, Section 0045-0093. Please use the IHC OARs to ensure that you have developed policies and procedures for all of the rules.

HFLC IHC Initial Agency FAQ last updated 02/2018

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